Gerry Steinberg MPIn the House...

Commons Gate

Improving Service Delivery:
The Veterans Agency (HC 522)

Public Accounts Committee 17 Sep 2003

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Wednesday 17 September 2003
Sir John Bourn KCB, Comptroller and Auditor General, further examined.
MR ROB MOLAN, Treasury Officer of Accounts, HM Treasury, further examined.
Improving Service Delivery: The Veterans Agency (HC 522)
Examination of Witnesses
Witnesses: MR ALAN BURNHAM, Chief Executive and DR PAUL KITCHEN, Director of Medical Services, The Veterans Agency, examined.

Q21 Mr. Gerry Steinberg (City of Durham): If I have time I would like to come back about the Gulf War Syndrome. First of all, can I say that I would congratulate you because I must admit that when I have contacted you, you were very efficient. I would not say that about many of the departments in the Civil Service, to be quite honest, but when I have contacted you I have always had a very good response. I was quite surprised when I looked at the Report, particularly on figure 34, page 34, because it seems that 70% of the claims for disablement pensions are made at least three years after the service person has left the Forces, and the bulk of the claims appear to be made after 27 years, is that right?

Mr Burnham: We do not routinely collect that data but, yes, the bulk of our clients are still World War Two veterans.

Q22 Mr. Gerry Steinberg (City of Durham): How can you be sure that is the case and that it is to do with the conflict of the Second World War and it is not just old age? I have aches and pains all over, I can hardly move. If I had been in any conflict I would have been coming to you for a pension.

Mr Burnham: I think that you strike at the very problem we have in terms of the length and the difficulty. If Mr Smith makes a claim to us today and says: "I fell off a tank in North Africa in 1943 and I think the arthritis in my right knee is to do with that", we have to pursue that. Now I think you could see in other litigation Mr Smith would be saying: "If you have not got any proof about that, that is the end of the matter". It is not the case with us. We have then to establish the service record and start having to look at the medicine. Now the balance of proof in the War Pensions Scheme does lean very much in terms of the claimant's favour and that is why we would be in a lengthy process - and Dr Kitchen and the medical staff - to make absolutely certain. If it is not proved beyond reasonable doubt, the claim can go in his favour.

Q23 Mr. Gerry Steinberg (City of Durham): How do people know about that after 27 years and they have not claimed before? How are they aware that they can claim?

Mr Burnham: Two things. I think the ex-service organisations do a tremendous amount of work in that, but also I would like to think that our own efforts working with the ex-service organisations over recent years have made a difference. We have done a lot over the last three or four years to increase and gain more variety in the way we try to bring to the attention of people that the War Pensions Scheme is available if you want to claim.

Q24 Mr. Gerry Steinberg (City of Durham): Things are hotting up, are they not, rather than slackening off? When do you think it will peak?

Mr Burnham: I would not say they are hotting up. For instance, compared with the peak of claims in the early 1990s, I think what we are seeing now is a steady flow of business. Inevitably, in terms of just the age, that large portion of our customers who are World War Two veterans will over the next ten to 15 years ----

Q25 Mr. Gerry Steinberg (City of Durham): You will be redundant in ten or 15 years' time, will you?

Mr Burnham: I think you would see a smaller operation, but not redundant I trust, although I think in ten years' time I would be doing something else.

Q26 Mr. Gerry Steinberg (City of Durham): You mentioned the ex-servicemen's organisations, how effective are they in informing their members of their war entitlements?

Mr Burnham: I think they are particularly effective. The Royal British Legion probably takes the lead on that, both in terms of their journal and publicity and we do lots of joint events with them.

Q27 Mr. Gerry Steinberg (City of Durham): I was informed that there was a sort of committee in each region, is that right?

Mr Burnham: There are War Pensions Committees, yes.

Q28 Mr. Gerry Steinberg (City of Durham): What is the role of that particular committee in the regions then? Who picks them? How are the Chairmen picked and things like that?

Mr Burnham: The Chairmen of the War Pensions Committees are appointed by the Secretary of State for Defence, as are the members of the committees. They have a number of functions. One is to monitor the performance of the Agency, in particular the performance of the Welfare Service. They can hear complaints from individual war pensioners who feel that we are not providing a proper service, or our decisions are incorrect. Also, they have a role to raise awareness about the services available under the War Pensions Scheme and the Welfare Service.

Q29 Mr. Gerry Steinberg (City of Durham): I am told by them that your particular organisation does not keep them informed very adequately.

Mr Burnham: I would say I am absolutely sure over the last two to three years since the committees were reconstituted that the level of involvement with the committees has increased enormously. I hold two conferences a year for the War Pensions Committees' Chairmen and do a personal briefing for them twice a year.

Q30 Mr. Gerry Steinberg (City of Durham): A member of one of the committees told me that he did not know how many cases were handled in the area, he did not know how much money had been allocated in the area, or anything like that. This was all kept from them, the information was withheld, is that right?

Mr Burnham: No. In so far as we can extract any information about case loads, et cetera, it is readily available to the War Pension Committees. Sometimes I have to say though it may not be cost-effective for us to extract data in that particular area, simply because it does cost us a lot to do that kind of computer scan.

Q31 Mr. Gerry Steinberg (City of Durham): I will move on then. If somebody gets a war pension, presumably it is for life, is it?

Mr Burnham: Generally, yes, once the decision has been made.

Q32 Mr. Gerry Steinberg (City of Durham): When there is a reassessment, presumably it is always to go up rather than to come down?

Mr Burnham: Not necessarily, no.

Q33 Mr. Gerry Steinberg (City of Durham): Not necessarily?

Mr Burnham: No. A case can be reviewed.

Q34 Mr. Gerry Steinberg (City of Durham): Has anybody ever recovered and come off the list altogether?

Mr Burnham: Yes, occasionally.

Q35 Mr. Gerry Steinberg (City of Durham): What percentage is awarded for a war pension for persons who have been involved in a conflict or a military exercise rather than a recreational or a civilian accident? Let me tell you why I ask this, I have two cases, they did not write. These people were writing and complaining about it. One hurt his leg playing football in an inter-services match and he got a war pension. The other one hurt his back playing the base drum in the band and he got a war pension. That seems a bit generous, does it not? I would have thought a war pension was for risking your life, not risking your back playing a drum or scoring the winning goal in an inter-services match.

Mr Burnham: I think that the name would lead a lot of people to believe that it is war-related, but it is simply any injury or disablement arising out of service. Because there is no requirement for it to be in on active service, we really have no data at all on how many claims would relate to active service, training or to any other course.

Q36 Mr. Gerry Steinberg (City of Durham): The definition of a war pension is very wide?

Mr Burnham: Very wide, it arises out of service. That is the full range of service, whether at peace, war, training, administration or whatever.

Q37 Mr. Gerry Steinberg (City of Durham): I have been told that you do not keep records about how veterans find out about your existence? Would this not be a sensible thing to do for obvious reasons?

Mr Burnham: Yes. I think the recommendation in the Report did pick out some things where we needed to give more attention. We have a variety of initiatives to try and raise awareness, but because we were not getting proper feedback about why people were getting in touch, it is difficult to judge their effectiveness. Just as an example, since the recommendation we had an arrangement with the Royal British Legion to send out 600,000 copies of our helpline leaflet in their magazine, and this time round we were able to track how many people who got in touch subsequently had done so because of that.

Q38 Mr. Gerry Steinberg (City of Durham): Let us say somebody applies for a war pension and they get it and then there is found to be a mistake. Would you then try and recover that money because presumably mistakes are made?

Mr Burnham: It would depend what you meant by a mistake.

Q39 Mr. Gerry Steinberg (City of Durham): The medical assessment was wrong or something like that?

Mr Burnham: By and large if the medical assessment was deemed to be wrong the pension would not be changed, unless that assessment had been made in the absence of a material fact. For example, if somebody just made a bad decision, even though we examined that decision afterwards and felt that was not a justifiable decision, the pension would not be changed. There are legislative constraints on that happening.

Q40 Mr. Gerry Steinberg (City of Durham): Finally, on page 28, paragraph 2.15, the paragraph is entitled "Financial accuracy". I read this paragraph as I read the Report and it seemed a pretty innocuous paragraph, but then I thought about it and read it again and it hides quite a bit, does it not, in the way it is written? It says: "...indicated the Agency was achieving 96%..."accuracy in finance, but that means it is 4% wrong. If it is 4% wrong you are dealing with, what is it, 200 and something thousand cases, 4% of that is something like 11,000 cases a year you pay the wrong amounts, that can turn out to be a lot of money, surely. If I remember rightly it says: "At the time of our earlier examination in 1992 the Agency was achieving similar levels of financial accuracy". There is a 4% error, which is quite a lot in terms of the numbers of people you deal with, and you have not improved at all since 1992. Why not?

Mr Burnham: I think two things. Firstly, I would like to stress that most of the errors that contribute to that are very small in terms of the financial amount. They arise usually where there is a more manual calculation, or where there is an error by one day plus or minus on the correct starting date for the pension. It would be very unusual, for instance, for us to find an error or if indeed a wrong rate of pension was awarded. Secondly, my experience - sort of wider across Social Security benefits - is that where you are dealing with human beings and human beings are making a calculation, if your accuracy rate is where we want it to be, pushing up towards I think 98%/99%, that is about as good as you get. I just do not think there are margins with human beings to do better.

Mr. Gerry Steinberg (City of Durham): You can appreciate from the tone of my questioning that I thought it was quite a good Report.


Q199 Mr. Gerry Steinberg (City of Durham): I wanted to come back on the Gulf War Syndrome issue and Mr Williams asked a few questions about it. In compensation terms, what you were saying was that anybody who says they have Gulf War Syndrome or Illness will get a war pension if it is proven they are ill or whatever, and you said therefore it would not make a lot of difference because they would be getting the pension anyway. What you did not explain more fully was that in fact they would get quite considerable compensation presumably if it was proven there was a Gulf War Syndrome and they were suffering from it because of either the depleted uranium they came in contact with or the toxic medicines which were given to them. I have a constituent who went away as a fit full-time active soldier and he came back, frankly, an absolute wreck. He bleeds externally for no reason, he bleeds internally for no reason, he has strokes, he has developed epilepsy, he has seizures and he has many other problems. He sees a neurologist, he sees an orthopaedic surgeon and he sees a rheumatologist; he has chronic fatigue syndrome. All this since he came back from the Gulf. Yet the experts say there is no such thing as Gulf War Syndrome and that is a load of poppycock as far as I am concerned, having seen this gentleman over the last two or three years. In the case of where the court made a decision, was that person awarded compensation?

Mr Burnham: No.

Q200 Mr. Gerry Steinberg (City of Durham): No compensation?

Mr Burnham: The decision was purely in relation to the labelling of his disablement for war pension terms.

Q201 Mr. Gerry Steinberg (City of Durham): So the court has actually stated he did have Gulf War Syndrome and he now presumably has the opportunity to sue the Ministry of Defence?

Mr Burnham: I have said we will give you a note on this.

Mr. Gerry Steinberg (City of Durham): I am not sure you did say that.

Chairman: Yes, he did.

Q202 Mr. Gerry Steinberg (City of Durham): Sorry.

Mr Burnham: The decision was in relation to a Pensions Appeal Tribunal solely upon the issue of the label which should be given to his disablement for war pension purposes. There are specifically no wider ramifications from that. The one thing that we in the Agency very consciously do acknowledge is that, irrespective of the label, people are genuinely ill, and not only in relation to Gulf War veterans are we providing pensions to the overwhelming majority of them but in terms of the support they get from the Welfare Service it is significant.

Q203 Mr. Gerry Steinberg (City of Durham): With great respect, Mr Burnham, that is not the point. The point is, if it is proven they have Gulf War Syndrome, they will be able to sue the Ministry of Defence for quite a considerable amount of compensation, and that is why the Ministry of Defence is holding out and saying there is no such thing as Gulf War Syndrome, is it not, because they know they are going to have to pay compensation if there is? This is a bit unfair on you because it is not your responsibility but if this constituent of mine went away a healthy, fit man, an active soldier, jumping out of aeroplanes and fighting the Iraqis in the first Gulf War and he comes back a nervous wreck, a physical wreck, it seems clear to me he got something from that action. Is there anywhere else in the world that actually recognises Gulf War Syndrome?

Mr Burnham: I do not know.

Q204 Mr. Gerry Steinberg (City of Durham): Do the Americans?

Mr Burnham: No.

Q205 Mr. Gerry Steinberg (City of Durham): They do not?

Mr Burnham: No.

Q206 Mr. Gerry Steinberg (City of Durham): When I asked a Parliamentary Question on this a number of years ago, the Minister at the time told me they were funding several programmes to find out whether Gulf War Syndrome actually exists or not. Are you aware of these programmes which have been funded?

Mr Burnham: Yes.

Q207 Mr. Gerry Steinberg (City of Durham): What is the progress on those programmes?

Dr Kitchen: The programmes are being overseen by the Medical Research Council who are advising the Ministry of Defence on the research programme. A number of them have reported which show there is an increased illness in Gulf veterans, who report almost twice the number of symptoms than non-Gulf veterans. So we do recognise Gulf veterans do suffer illness. However, none of the research to date has demonstrated the existence of the discrete syndrome which is defined as a collection of science and symptoms which assimilate to a distinct clinical entity. These research programmes have shown these symptoms exist in other people who have not served in the Gulf although not to the same level of frequency.

Mr. Gerry Steinberg (City of Durham): I would like to go on but I have been told I cannot.

Chairman: You have made your points very well.

Q208 Mr. Gerry Steinberg (City of Durham): Could I just ask, Sir John, is it possible this could come under a separate report? Is it in your brief or not?

Sir John Bourn: The question of money spent on analysing people's illnesses in service, like all money spent, does mean I have a standing in the matter. So, as with the medals, I will think about it, Mr Steinberg.

Mr. Gerry Steinberg (City of Durham): Good.

Mr Bacon: Could I make a point related to this? I went to the Falkland Islands last year and I was shocked to read that more people have committed suicide who served in the Falklands than who were killed in the Falklands. The same is true of the Vietnam War, I do not know if the same is true of the Gulf War or not. I think it would be interesting to look at the expenditures which are involved in looking after people who are survivors of wars - as Sir John says, he does have a standing in that - and whether, as Mr Steinberg says, there is more which could be done.

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